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PART I - MEMBER COMPLETES THIS SECTION TO …

STATEMENT TO SUBSTANTIATE PAYMENT OF FAMILY SEPARATION ALLOWANCE (FSA) PRIVACY ACT STATEMENT AUTHORITY: PRINCIPAL PURPOSE: ROUTINE USES: DISCLOSURE: Title 37, U.S. Code, Section 427. To evaluate member's application for FSA. a. Serves as substantiating document for FSA payments and input into the member's pay …

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  Family, Separation, Family separation

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